scholarly journals Treatment of Internal Carotid Artery Dissections with Endovascular Stent Placement: Report of Two Cases

2001 ◽  
Vol 2 (1) ◽  
pp. 52 ◽  
Author(s):  
Deok Hee Lee ◽  
Seung Ho Hur ◽  
Hyeon Gak Kim ◽  
Seung Mun Jung ◽  
Dae Sik Ryu ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Stent Placement ◽  
Internal Carotid ◽  
Endovascular Stent ◽  
Endovascular Stent Placement

scholarly journals Endovascular Treatment of Extracranial Internal Carotid Pseudoaneurysm: Description of Three Cases

2016 ◽  
Vol 02 (02) ◽  
pp. e15-e18 ◽  
Author(s):  
Andrea Giorgianni ◽  
Carlo Pellegrino ◽  
Camilla Micieli ◽  
Anna Mercuri ◽  
Renzo Minotto ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Endovascular Treatment ◽  
Surgical Approach ◽  
Stent Placement ◽  
Internal Carotid ◽  
Carotid Dissection ◽  
Endovascular Stent ◽  
Artery Pseudoaneurysm ◽  
Endovascular Stent Placement

The aim of this study is to explore the possibility of endovascular treatment of internal carotid artery pseudoaneurysm (PSA). These lesions are difficult to treat with a surgical approach, especially if they are located extracranially and close to the skull base. Endovascular stent placement in symptomatic and unstable extracranial internal carotid PSA was found to be safe and effective. Depending on hemodynamic aspects, complete local exclusion of aneurysmal formation is achieved in few months. We present three patients with carotid dissection and PSA formation that have been successfully treated by stent placement.

Recurrent stenosis of common carotid—intracranial internal carotid interposition saphenous vein bypass graft caused by intimal hyperplasia and treated with endovascular stent placement

1999 ◽  
Vol 90 (3) ◽  
pp. 571-574 ◽  
Author(s):  
Jeffrey W. Brennan ◽  
Michael K. Morgan ◽  
William Sorby ◽  
Verity Grinnell
Keyword(s):  
Carotid Artery ◽  
Stent Placement ◽  
Intimal Hyperplasia ◽  
Internal Carotid ◽  
Bypass Graft ◽  
Endovascular Stent ◽  
Bypass Grafts ◽  
Endovascular Techniques ◽  
Vein Bypass ◽  
Endovascular Stent Placement

✓ Intimal hyperplasia is a well-known cause of delayed stenosis in vein bypass grafts in all types of vascular surgery. Options for treatment of stenosis in peripheral and coronary artery bypass grafts include revision surgery and the application of endovascular techniques such as balloon angioplasty and stent placement. The authors present a case of stenosis caused by intimal hyperplasia in a high-flow common carotid artery—intracranial internal carotid artery (IICA) saphenous vein interposition bypass graft that had been constructed to treat a traumatic pseudoaneurysm of the intracavernous ICA. The stenosis recurred after revision surgery and was successfully treated by endovascular stent placement in the vein graft. The literature on stent placement for vein graft stenoses is reviewed, and the authors add a report of its application to external carotid—internal carotid bypass grafts. Further study is required to define the role of endovascular techniques in the management of stenotic cerebrovascular disease.

scholarly journals Indications and Problems of Intracranial Stenting Report of Two Cases

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 149-154
Author(s):  
J. Deguchi ◽  
T. Kuroiwa ◽  
S. Nagasawa ◽  
G. Satoh ◽  
T. Ohta
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
External Force ◽  
Stent Placement ◽  
Internal Carotid ◽  
Total Occlusion ◽  
Intracranial Stenting ◽  
Linear Portion ◽  
Vertebrobasilar Artery ◽  
Intracranial Arteries

There have been few reports of stenting in the intracranial arteries. We used coronary stents in the chronically occluded intracranial vertebral artery and stenosis of internal carotid artery by the external force, and good blood flow were resumed. Stenosis in the intracranial arteries is also a good indication for stent placement when it is due to chronic total occlusion or artery compression by external force. But stent placement in the intracranial arteries has some problems. Stent placement in the intracranial artery is indicated only when the site of stent placement has a diameter of 3 mm or more, is a relatively linear portion of the vertebrobasilar artery or the internal carotid artery proximal to the C3 segment, and does not branch off perforating arteries or is already completely occluded.

scholarly journals An Ultrasound Model to Predict the Short-Term Effects of Endovascular Stent Placement in the Treatment of Carotid Artery Stenosis

2021 ◽  
Vol 7 ◽  
Author(s):  
Sheng-Jiang Chen ◽  
Rui-Rui Liu ◽  
Yi-Ran Shang ◽  
Yu-Juan Xie ◽  
Xiao-Han Guo ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Stent Placement ◽  
Carotid Artery Stenosis ◽  
Resistance Index ◽  
Peak Systolic Velocity ◽  
Artery Stenosis ◽  
Endovascular Stent ◽  
Improvement Rate ◽  
Preoperative Ultrasound ◽  
Endovascular Stent Placement

Purpose: The present study aimed to explore the predictive ability of an ultrasound linear regression equation in patients undergoing endovascular stent placement (ESP) to treat carotid artery stenosis-induced ischemic stroke.Methods: Pearson's correlation coefficient of actual improvement rate (IR) and 10 preoperative ultrasound indices in the carotid arteries of 64 patients who underwent ESP were retrospectively analyzed. A predictive ultrasound model for the fitted IR after ESP was established.Results: Of the 10 preoperative ultrasound indices, peak systolic velocity (PSV) at stenosis was strongly correlated with postoperative actual IR (r = 0.622; P < 0.01). The unstable plaque index (UPI; r = 0.447), peak eccentricity ratio (r = 0.431), and plaque stiffness index (β; r = 0.512) moderately correlated with actual IR (P < 0.01). Furthermore, the resistance index (r = 0.325) and the dilation coefficient (r = 0.311) weakly correlated with actual IR (P < 0.05). There was no significant correlation between actual IR and the number of unstable plaques, area narrowing, pulsatility index, and compliance coefficient. In combination, morphological, hemodynamic, and physiological ultrasound indices can predict 62.39% of neurological deficits after ESP: fitted IR = 0.9816 – 0.1293β + 0.0504UPI – 0.1137PSV.Conclusion: Certain carotid ultrasound indices correlate with ESP outcomes. The multi-index predictive model can be used to evaluate the effects of ESP before surgery.

Abstract TP467: Effects of the Tortuosity of the Cervical Internal Carotid Artery on Procedural Outcomes of Stent Placement

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Iqra N Akhtar ◽  
Raza S Hyder ◽  
Vamshi Balasetti ◽  
Nitish Kumar ◽  
Jacqueline J Kraus ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Stent Placement ◽  
Internal Carotid ◽  
Consecutive Series ◽  
Complication Rates ◽  
Grade 5 ◽  
Vessel Tortuosity ◽  
Grade 3 ◽  
Cervical Internal Carotid Artery

Introduction: Severe tortuosity of the cervical internal carotid artery distal to the stenosis may prevent successful placement of distal protection device and increase the risk of dissection and/or ischemic stroke. Objective: To assess and categorize the effects of tortuosity of the cervical internal carotid artery distal on procedural times, and peri-procedural complications in patients treated with carotid artery stent placement. Material and Methods: We analyzed the angiographic images and clinical data for a consecutive series of patients treated with stent placement over an 18-month period and graded the tortuosity as follows: Grade 0 is no vessel turns; Grade 1 (MILD) is 1 vessel turn, >90 degrees; Grade 2 (MODERATE) is 1 vessel turn, ≤90 degrees; Grade 3 (SEVERE) is 2 vessel turns, any angle; Grade 4 (SEVERE) is two vessel segments which are parallel to due to interspersed loop; Grade 5 (SEVERE) is a complete vessel loop (360 degrees). Technical complications including unsuccessful attempts to cross the stenosis with interventional devices, unutilized distal embolic protection, iatrogenic dissection, and ischemic events were ascertained. Results: A total of 80 patients were identified who underwent stent placement; mean (SD) 67.4 (8), 60 (75%) were men. Forty-three patients (53.8%) had evidence of stroke on non-invasive imaging prior to stent placement. In sixty-five cases, stent placement was performed electively (81.3%), emergently in fifteen cases (18.8%). The tortuosity was graded as 1 (46.2%), 2 (11.3%), 3 (15%), 4 (6.3%), and 5 (2.5%). Of the 80 patients, eighteen (22.5%) had severe tortuosity of grade 3 or higher. Mean procedural time (SD) was significantly greater with severe vessel tortuosity compared to mild to moderate vessel tortuosity (51.6 (6.2) versus 42.3 (5.2) minutes, p=.042). Technical complication rates were not significantly different with severe vessel tortuosity compared with mild to moderate vessel tortuosity (7% vs 9% p=.53). One intra-procedural dissection occurred in a case of severe tortuosity (grade 5). Conclusions: Severely tortuous internal carotid arteries distal to the stenosis can be seen in one fifth of patients undergoing carotid stent placement and is associated with increased procedural times.

Patient presentation, angiographic features, and treatment of strangulation-induced dissection of the internal carotid artery

2000 ◽  
Vol 92 (3) ◽  
pp. 481-487 ◽  
Author(s):  
Adel M. Malek ◽  
Randall T. Higashida ◽  
Van V. Halbach ◽  
Christopher F. Dowd ◽  
Constantine C. Phatouros ◽  
...  
Keyword(s):  
Domestic Violence ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Stent Placement ◽  
Internal Carotid ◽  
Artery Dissection ◽  
Percutaneous Angioplasty ◽  
Consistent Finding ◽  
Content Type ◽  
Fine Print

✓ Domestic violence leading to strangulation by an abusive spouse can cause carotid artery dissection. This phenomenon is rare and has been described in only three previous instances. The authors present their management strategies in three additional cases.Three young women aged 24 to 43 years were victims of manual strangulation committed by their spouses 3 months to 1 year before presentation. Two of the patients suffered delayed cerebral infarctions before presentation and angiography demonstrated focal, mirror-image severe residual stenoses in the high-cervical internal carotid artery (ICA), which were characteristic of a healed chronic dissection; there was no evidence of fibromuscular dysplasia. One of these patients underwent unilateral percutaneous angioplasty with stent placement, and the other underwent bilateral percutaneous angioplasty. Both patients have recovered from their strokes and remain clinically stable at 8 and 20 months posttreatment, respectively. The third patient presented with bilateral ischemic frontal watershed infarctions resulting from an occluded left ICA and a severely narrowed right ICA. Given the extent of the established infarctions, this case was managed with a long-term regimen of anticoagulation medications, and the patient remains neurologically impaired.These cases illustrate the susceptibility of the manually compressed ICA to traumatic injury as a result of domestic violence. They identify bilateral symmetrical ICA dissection as a consistent finding and the real danger of delayed stroke as a consequence of strangulation. Endovascular therapy in which percutaneous angioplasty and/or stent placement are used can be useful in treating residual focal stenoses to improve cerebral perfusion and to lower the risk of embolic or ischemic stroke.

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